Postoperative recovery in older adults undergoing cardiac surgery is a complex and multidimensional process associated with clinical, psychological, and nutritional factors; however, these factors are often addressed separately in clinical practice.

This study aimed to evaluate the clinical, psychological, and nutritional factors associated with postoperative recovery in patients aged 65 years and older undergoing cardiac surgery.

This descriptive cross-sectional study was conducted with 128 elderly patients undergoing elective cardiac surgery. Preoperative data included demographic and clinical characteristics, nutritional status (MNA-SF), quality of life (SF-12), and surgery-specific anxiety (ASSQ). Postoperative recovery was assessed before discharge using the Postoperative Recovery Index (PRI). Data were analyzed using descriptive statistics, correlation, and multivariable linear regression.

The mean PRI score was 2.59 ± 0.53, indicating moderate to severe recovery difficulty in most patients. Lower MNA-SF score and higher surgery-specific anxiety were significantly associated with greater recovery difficulty. Mental quality of life was negatively associated with recovery difficulty, whereas no significant association was found with physical quality of life. In multivariable analysis, surgery-specific anxiety emerged as the strongest factor associated with recovery difficulty. Higher age, body mass index, presence of chronic disease, longer ICU intubation duration, and longer ICU stay were associated with greater recovery difficulty, whereas higher MNA-SF scores and more frequent mobilization were associated with better recovery outcomes.

Postoperative recovery in older adults is associated with surgery-specific anxiety, nutritional status, and mental well-being. These findings highlight the importance of integrating psychological support, nutritional care, and early mobilization into perioperative nursing practice.